MEDICARE: MS. BETH SHEFFIELD MOLTER P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9105680	FL

General Provider Information

NPI Number	:	1881995074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BETH SHEFFIELD MOLTER P.A.-C

Provider Business Mailing Address
First Line	:	2804 REMINGTON GREEN CIR
Second Line	:	SUITE 2
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8707
Country	:	US
Telephone Number	:	850-385-4494
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 W RIVER RD
Second Line	:
City	:	WEWAHITCHKA
State	:	FL
Zip	:	32465-4533
Country	:	US
Telephone Number	:	850-639-5828
Fax Number	:	850-639-5536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	05/05/2017

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